The most recent attempt to overhaul the nation’s health care system would fundamentally alter Medicaid and jeopardize home and community-based services, according to www.DisabilityScoop.com. A chart outlining the proposed bill is available here.

After a prior Republican plan to repeal and replace the Affordable Care Act failed, this new effort in the U.S. Senate again seeks to upend the Obama-era law.

The proposal introduced last week by Sens. Lindsey Graham, R-S.C., Bill Cassidy, R-La., Dean Heller, R-Nev., and Ron Johnson, R-Wis. runs into a deadline of September 30. After that date, a simple majority will not suffice to pass the measure – rather, 60 votes would be needed to do so.

Thus, Republicans have until Sept. 30 to repeal Obamacare with only 51 votes in the Senate under the current budget resolution.

Continue Reading New Healthcare Bill Would Impact Medicaid Services

Mandatory Arbitration in Nursing Home Admission Contracts

A proposed rule change introduced by the Trump administration would authorize mandatory, pre-dispute arbitration in long-term care admissions contracts. The proposed rule is in response to an Obama administration rule that prohibited federal funding for long-term care facilities that required residents to resolve disputes through arbitration.

ABA Writes Letter Opposing Rule Change

In a recent letter, the American Bar Association (ABA) advocates for the Centers for Medicare and Medicaid Services (CMS) to retain its current rule prohibiting long-term care facilities from entering into binding arbitration agreements with residents until after a dispute arises. In the letter sent to CMS administrator Seema Verma, the ABA writes that implementing the proposed rule would harm residents’ rights and interests.

Continue Reading ABA Resists Mandatory Arbitration Clauses in Nursing Home Admissions Contracts

When a loved one moves into a nursing home, staff members have a duty to continually provide the resident with the appropriate level of nursing care, medical care and personal attention.

Nursing home staff members are responsible for the residents’ well-being and are required to report all signs of abuse or neglect, including those arising from resident-to-resident interactions.

One form of abuse or neglect that may be overlooked by staff members is senior bullying. Continue Reading Is My Elderly Parent Being Bullied?

To increase protection of its elderly and disabled citizens from abuse and neglect, the state of New Jersey is expanding its Safe Care Cam program to nursing homes, residences for the developmentally disabled, and other institutional care facilities. The Safe Care Cam program loans free surveillance cameras to New Jersey residents to monitor the treatment provided by caregivers. The cameras are provided for free 30-day loans to families who suspect or question whether a care provider is abusing or neglecting their loved one.

Continue Reading New Jersey’s Safe Care Cam Program Expanded to Nursing Homes

Without a hearing, our new congress wasted no time in trying to severely limit damages in nursing home abuse claims. A newly proposed law called the Protecting Access to Care Act of 2017 H.R. 1215, seeks to limit non-economic damages in all medical cases to $250K for everyone in the country.

Continue Reading New Congress Trying to Protect Corporations from Nursing Home Abuse Claims

In its five-part “Failing the Frail” series, a PennLive investigation reveals the 18 most understaffed Pennsylvania nursing homes. The series includes an interactive map to search for staffing levels of individual nursing homes.

Based on PennLive’s analysis of 559 facilities, nursing homes in Pennsylvania provided residents with an average of only 3.6 hours of care per day, well below the minimum 4.1 hours recommended for safe care, although within Pennsylvania’s minimum staffing requirement of 2.7 hours of care per day. The analysis found 477 homes, or 85 percent, provided less than the recommended level. The analysis further found that 183 homes, or 33 percent, were dangerously understaffed because they provided less than 3.5 hours of care per day and, less than 32 minutes of care from registered nurses.

Continue Reading Pennsylvania Nursing Homes Often Understaffed

During much of the 20th century, hospitals did not have a duty to treat patients who entered emergency departments. Without any given reason, they could refuse to treat certain patients. The practice of “patient dumping” arose from that lack of duty.

Patient dumping refers to situations when hospitals deny emergency medical screening and stabilization services. It also refers to instances when a hospital transfers an individual to another hospital after discovering that the individual does not have insurance or a means to pay for treatment.

To correct that wrong and in an effort to ensure that individuals received needed emergency care, in 1986 Congress enacted EMTALA, which was designed to protect all individuals seeking evaluation or treatment at hospital emergency departments that participate in Medicare. Continue Reading Patient Dumping and the Emergency Medical Treatment and Labor Act (EMTALA)

According to Medicare fraud reports by the U.S. Department of Human Health and Services (HHS), the U.S. Department of Justice’s Medicare Fraud Strike Force team has investigated $7 billion in fraudulent billing since 2007 and prosecuted over 2400 medical professionals and administrators. Part of that amount comes from nursing homes that bill for unnecessary services or for services that have not been provided to the residents that depend on them.

And that fraudulent activity harms nursing home residents as well as our government’s bottom line.

Continue Reading How Nursing Home Staff Can Help Prevent Medicare Fraud

Our practice group has often written about how corporations unfairly use predispute arbitration agreements to sidestep the civil-justice system and gain disproportionate advantage when addressing their negligent conduct in arbitration.

Often times, corporations slip arbitration clauses into the admission papers and process—at a time when the family is justifiably thinking about the loved one’s health, wellbeing, and quality of life. They are not thinking about their preferred method for resolving a hypothetical legal dispute that may or may not occur in the future.

Now, numerous lawmakers have echoed our sentiment by stating that corporations that use predispute arbitration clauses at nursing homes make it more difficult for negligence and abuse victims to seek redress. On September 23, 2015, U.S. Senator Al Franken led a 34-Senator coalition in calling on the Centers for Medicare and Medicaid Services (CMS) to outlaw predispute arbitration clauses in contracts with long-term care facilities like nursing homes. (Read the letter here)

The letter explains that the “decision to admit yourself or a loved one to a long-term care facility can be difficult. Unfortunately, families often have limited choices due to cost and location constraints. Yet, long-term care facilities sometimes force and often encourage potential residents and their families to waive their legal rights before any harm has occurred and to agree to a dispute resolution forum that may be biased in favor of the facility.”

And, because families are rightly focused on their loved one’s wellbeing during the admission process, the letter explains that “only an arbitration agreement that is entered into after an incident has occurred and after a resident has considered all their legal rights can ensure that resident and their families are not deprived of their rights.”

A shareholder in our Nursing Home Litigation Group explains: “When admitting a resident, if you see these documents slipped into the admission paperwork, don’t sign them! You don’t have to, and you’re only hurting yourself if you do. If you’ve already signed one, tell the administrator you want to cancel it.”

No family wants to believe that a nursing home or an assisted living facility would hurt their loved one, but it happens all too often. If you or someone you know has been involved in a nursing-home negligence or abuse incident, consult with an attorney immediately to discuss your rights.

In nursing-home neglect and abuse cases, the victims of the nursing-home negligence or abuse often suffer from some form of dementia, including Alzheimer’s, which is a specific type of dementia that accounts for 60 to 80 percent of dementia cases.

Alzheimer’s is a progressing disease. That means that it worsens over time, causing cognitive and behavioral problems. For example, cognitively, a person may have difficulty thinking and trouble understanding. They may also experience forgetfulness, confusion, and disorientation. And behaviorally, a person may exhibit irritability, agitation, lack of restraint, and difficulty with self care.

Behavioral Changes

For many, the behavioral changes present the most challenging and distressing symptoms from Alzheimer’s. The symptoms stem from a progressive brain-cell deterioration. Importantly, they may become worse through medication, environmental influences, and some medical conditions.

Environmental Triggers for Behavior Changes

Beyond the physiological reason for the behavior symptoms, changes in a person’s surroundings also often play a role in triggering those symptoms.

When I interview family members and nursing-home nurses in preparation for litigating a nursing-home negligence or abuse case, they often describe events or changes in the person’s surroundings that have created additional stress that can be difficult for an Alzheimer’s patient to manage. Some of those events and changes include:

  • Moving to a new residence, nursing home or new room within a nursing home;
  • Changes in a familiar environment or caregiver arrangements;
  • Misperceived threats;
  • Admission to a hospital; or,
  • Being asked to bathe or change clothes.

So, while the patient is trying to make sense out of an increasingly confusing world, those environmental factors increase the patient’s fear and fatigue while exacerbating the patient’s exiting irritability, agitation, lack of restraint, and difficulty with self care.

Standard of Care for Nursing Homes

Nursing homes and the nursing-home corporations that operate them know, and have reason to know, that environmental changes place the Alzheimer’s or dementia patient at greater risk of experiencing a serious nursing-home injury.

When I depose a Director of Nursing in a nursing-home neglect and abuse case, the nursing director admits and acknowledges the serious risk of injury that Alzheimer’s patients face while in the nursing-home facility. Also, the nursing director admits that the nursing-home corporation and its nursing staff must provide those patients with treatment and services that meet a specific standard of care.

The standard of care requires that the nursing home develop an individualized care plan to promote the patient’s health, protect the patient’s safety, and secure the patient’s dignity. The nursing-home staff must implement the treatment and care, from the care plan, on a daily basis—without fail. And then, the nursing home must evaluate that treatment and care to ensure its effectiveness and make changes to the plan when appropriate.

Nursing Home Negligence and Abuse

When a nursing-home corporation and its nursing-home staff follow the required standard of care, the nursing home can prevent the patient from experiencing preventable catastrophic falls, avoidable pressure ulcers, and other serious injuries.

If the nursing-home corporation and the nursing-home staff fail to follow the required standard of care, then the patient may experience serious physical injury, and the nursing-home corporation is responsible for the harms and damages that follow. If you or someone you know has been involved in a nursing home negligence incident it is recommended that you consult with an attorney immediately to discuss your rights.